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Related Experiment Video

Updated: May 24, 2026

Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy
11:38

Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy

Published on: July 3, 2014

Radiation Therapy De-escalation in Breast Cancer Patients With Pathologic Complete Response: An Integrated Analysis

Jian Wang1, Jing Ning1, Simona F Shaitelman2

  • 1Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.

International Journal of Radiation Oncology, Biology, Physics
|May 22, 2026
PubMed
Summary

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Cancer Survival Analysis01:21

Cancer Survival Analysis

Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...

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For breast cancer patients achieving a pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC), adjuvant radiotherapy (RT) offers minimal overall survival (OS) benefit. These findings support selective RT de-escalation and personalized treatment decisions.

Area of Science:

  • Oncology
  • Radiotherapy
  • Breast Cancer Research

Background:

  • Neoadjuvant chemotherapy (NAC) has improved pathologic complete response (pCR) rates in breast cancer.
  • The necessity of adjuvant radiotherapy (RT) after NAC in patients with excellent response requires reevaluation.
  • Current practices often involve whole-breast RT regardless of breast response, leaving the safety of omitting RT uncertain.

Purpose of the Study:

  • To evaluate the long-term overall survival (OS) with versus without adjuvant RT in patients achieving pCR after NAC and breast-conserving surgery.
  • To assess OS across varying local-regional recurrence (LRR) risks and time-to-recurrence distributions.
  • To integrate real-world evidence, clinical trial data, and simulated extensions for robust analysis.

Main Methods:

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Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy
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Voluntary Breath-hold Technique for Reducing Heart Dose in Left Breast Radiotherapy

Published on: July 3, 2014

  • Integrated analysis of real-world evidence, clinical trial data, and simulated extensions.
  • Evaluation of overall survival (OS) in patients with pathologic complete response (ypT0 ypN0) post-NAC.
  • Assessment of OS based on local-regional recurrence (LRR) risks and time-to-recurrence data.

Main Results:

  • Adjuvant radiotherapy (RT) demonstrated small overall survival (OS) gains across different stages.
  • For stage I disease, RT yielded a 1.6% OS difference (85.6% vs 84.0%) requiring over 12,000 patients for statistical power.
  • For stage II-III disease, RT showed a 3.3% OS difference (81.6% vs 78.3%), necessitating approximately 3,800 patients for adequate power.

Conclusions:

  • The projected OS benefit of adjuvant RT in patients achieving pCR after NAC is minimal.
  • RT de-escalation warrants further investigation, particularly in subgroups with favorable biology and excellent response.
  • Findings support response-adapted decision frameworks and integrating pCR into future RT guidelines for personalized care.